Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, September 26, 1995 TAG: 9509260020
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: JANE BRODY
DATELINE: LENGTH: Long
Even those who have accepted their ample bodies or middle-age spread and who scoff at fashion-model thinness were alarmed to learn that those 25 pounds they've put on since high school or the extra weight they've carried all their lives might kill them.
While there is no debate about the risks to health and life associated with frank obesity, defined as weighing at least 30 percent more than is desirable for one's height and frame, moderately overweight people have long assumed that their main concern was a cosmetic one. Now, it seems, they should be more worried about their health and life expectancy than about how they look.
Based on the new findings from a 16-year study of 115,000 female nurses and similar findings from a continuing study of 19,000 men who graduated from Harvard, about 300,000 deaths a year in this country can be attributed to excess weight.
This projection, made by the study's principal author, Dr. JoAnn E. Manson of Brigham and Women's Hospital and Harvard Medical School in Boston, may even be a conservative one, because the women and men being studied are better educated, more affluent and presumably more health-aware than the average American, and are therefore likely to have lower death rates.
Furthermore, most of the women in the nurses' study have yet to reach the age when heart disease, the health problem most powerfully influenced by overweight, emerges as the leading killer.
At the time the data were analyzed, the women's ages ranged from 46 to 71 and cancer was their main cause of death. Manson said she was astonished to discover that nearly one-third of the 2,586 deaths from cancer - especially cancers of the breast, colon and endometrium - could be attributed to overweight.
The new study examined two questions: the risks of gaining weight (22 pounds or more) after age 18 and the risks related to being heavier than the leanest women.
Among women who had never smoked, those who weighed about 15 percent less than the average American woman of the same height were least likely to die during the study. For example, the average American woman is 5 feet 5 inches tall and weighs 150 to 160 pounds, which the new study suggests is about 30 pounds too many to maximize one's chances of living to a healthy old age.
Those who weighed less than 120 had the lowest death rates, but chances of an early death were 20 percent higher among those who weighed 120 to 150 pounds and 30 percent higher among those who weighed 150 to 160 pounds. In other words, even women of average weight and those mildly overweight have higher death rates than the leanest women.
Although previous studies have concluded that the leanest men and women have higher death risks than those slightly heavier, most of these studies did not separate former smokers from people who had never smoked, and some did not take into account the possibility that an undiagnosed illness might have accounted for thinness in many of the people who died during the studies.
In the new study, which took account of those factors, the risks of ``dying prematurely,'' or sooner than the leanest women, jumped more dramatically - 60 percent among those 5 feet 5 inches tall and weighing 161 to 175 pounds; 110 percent among those weighing 176 to 195 pounds, and 120 percent among those weighing more than 195 pounds.
Similar risks were found among women who gained weight as adults. Compared with those who gained less than 10 pounds after age 18, those who gained 22 to 40 pounds experienced a 70 percent increase in cardiovascular deaths and a 20 percent increase in cancer deaths. Those gaining more than 40 pounds were seven times as likely to die of heart disease during the study and 50 percent more likely to die of cancer.
What do such numbers mean to the millions of Americans whose college blazers no longer meet in the middle?
First, it is helpful to realize that a woman's risk of dying in midlife is not great.
Heart disease is not a common occurrence among women under 65, so even a sevenfold increase in cardiac deaths for a woman in her 50s is still a low risk of dying. Of the 4,726 deaths that occurred among the nurses, only 881 were because of cardiovascular disease.
Cancer, on the other hand, is the leading killer of middle-aged women - there were 2,586 cancer deaths during the study - so even a relatively small increase in risk can be meaningful.
Keep in mind, too, that the study measured deaths, not incidence of disease; far more women are likely to have been afflicted with weight-related illnesses than to have died as a result.
Furthermore, a small increase in the risk of disease and death among the mildly overweight is likely to mean more to society at large than to each individual.
A 20 percent increase in premature deaths, and an even greater increase in nonfatal illness, occurring among more than 100 million middle-aged adults adds up to a lot of lost years of productive life and some very big medical bills for society to absorb.
But to slightly pudgy individuals, a 20 percent increase in an initially low risk may not seem like much.
First, do not panic. If you have put on a dozen or more pounds since high school but still weigh within a desirable range (less than the equivalent of 150 pounds for a 5-foot 5-inch woman or man), the increase in your risk of premature death is quite small and may not warrant any attention to the actual numbers on the scale, as long as you adopt health-promoting living habits and do not smoke.
by CNB